Gelatin-Sealed Dacron Graft is not more Susceptible to MRSA Infection than PTFE Graft

ObjectivesThe purpose of this experimental study was to compare the susceptibility of gelatin-sealed Dacron and PTFE prostheses to infection by MRSA.DesignProspective, randomized, controlled animal study.Materials and MethodsGraft infections were established in the subcutaneous tissues of 60 female Spraque-Dawley rats by the implantation of gelatin-sealed Dacron or PTFE prostheses followed by topical inoculation with methicillin-resistant Staphylococcus aureus. The study groups were as follows: (1A) uncontaminated gelatin-sealed Dacron group, (1B) untreated contaminated gelatin-sealed Dacron group, (1C) contaminated gelatin-sealed Dacron group with intraperitoneal teicoplanin treatment, (2A) uncontaminated PTFE group, (2B) untreated contaminated PTFE group, and (2C) contaminated PTFE group with intraperitoneal teicoplanin treatment. The grafts were removed after 7 days and evaluated for infection by counting the number of adherent bacteria on the graft material after rinsing and sonication. The perigraft tissue was harvested for histopathological study. To investigate the existence of any infection, blood samples were collected by cardiopuncture for a culture analysis.ResultsNo significant difference in bacteria counts was observed between gelatin-sealed Dacron and PTFE grafts. In groups 1A and 2A, there was no infection detected. The bacterial counts for MRSA were 7.4×105 in group 1B and 8.6×105 in group 2B. There was also no infection in groups 1C and 2C. While the difference between group 1B and 2B was not significant (p>.05), bacterial counts in group 1B or 2B were significantly higher than those in other groups. Blood cultures were only positive in four rats in group 1B and in two rats in group 2B. The severities of the inflammation of the perigraft tissues was low in groups 1A and 2A, high in groups 1C and 2C, and between the range from low to moderate in groups 1B and 2B.ConclusionThe susceptibility of gelatin-sealed Dacron to bacterial infection was not higher than that of PTFE

Outdoor education camp and group cohesion: an investigation in the teacher education institute of Malaysia

The study seeks to investigate the effect of outdoor education camp toward group cohesion among second year undergraduate teacher trainees from selected Teacher Education Institutes of Malaysia. A pre-test and post-test approach with non-equivalent control group was utilised among 350 second year undergraduate teacher trainees from four selected campuses. A modified version of Group Environment Questionnaire (GEQ) was used to gather data from pre-test and post-test. Results from MANCOVA procedures suggested that the camp had positively improved the group cohesion aspects of the experimental group with significant gain in ATG-T, ATG-S, GI-T and GI-S. Furthermore, results also highlight the improvement of group outcome aspects (GI-T and GI-S) which surpassed individual aspects (ATG-T and ATG-S). Overall, the results of this study showed that outdoor education improves teacher trainees’ group cohesion.Keywords: outdoor education; cohesion; teacher; adventure

Efficacy of Vancomycin, Teicoplanin and Fusidic Acid as Prophylactic Agents in Prevention of Vascular Graft Infection: An Experimental Study in Rat

AbstractObjectivesTo compare the efficacy of a single prophylactic dose of intra-peritoneal vancomycin and teicoplanin with anti-biotic treated Dacron grafts (vancomycin, teicoplanin, 10 or 40% fusidic acid-soaked grafts) in preventing vascular graft infections in a rat model.DesignProspective, randomized, controlled animal study.Materials and methodsThe graft infections were established in the subcutaneous tissues of 80 female Sprague–Dawley rats by the implantation of Dacron prostheses followed by the topical inoculation with methicillin-resistant Staphylococcus aureus. The study groups were as follows: (1) uncontaminated control group, (2) untreated contaminated group, (3) contaminated group with intra-peritoneal vancomycin, (4) contaminated group with intra-peritoneal teicoplanin, (5) contaminated group received vancomycin-soaked Dacron graft, (6) contaminated group received teicoplanin-soaked Dacron graft, (7) contaminated group received 40% fusidic acid-soaked Dacron graft, and (8) contaminated group received 10% fusidic acid-soaked Dacron graft prophylaxis. The grafts were removed after 7 days and evaluated by a quantitative culture analysis.ResultsNo infection was detected in controls. The untreated contaminated group had a high bacteria count (6.0×104CFU/cm2 Dacron graft). Groups that received intra-peritoneal vancomycin or teicoplanin had less bacterial growth (4.8×103 and 3.9×103CFU/cm2 Dacron graft, respectively). Similarly, the group that received 10% fusidic acid-soaked graft showed less bacterial growth (3.6×103CFU/cm2 Dacron graft). The groups with vancomycin-, teicoplanin- and 40% fusidic acid-soaked grafts showed no evidence of infection. Statistical analyses demonstrated that intra-peritoneal prophylactic antibiotic treatment was less effective in inhibiting bacterial growth than high concentration antimicrobial-soaking of grafts.ConclusionThe use of vancomycin-, teicoplanin- and 40% fusidic acid-soaked grafts was effective in preventing primary prosthetic vascular graft infection

Can local application of Tranexamic acid reduce post-coronary bypass surgery blood loss? A randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Diffuse microvascular bleeding remains a common problem after cardiac procedures.</p> <p>Systemic use of antifibrinolytic reduces the postoperative blood loss.</p> <p>The purpose of this study was to examine the effectiveness of local application of tranexamic acid to reduce blood loss after coronary artery bypass grafting (CABG).</p> <p>Methods</p> <p>Thirty eight patients scheduled for primary isolated coronary artery bypass grafting were included in this double blind, prospective, randomized, placebo controlled study.</p> <p>Tranexamic acid (TA) group (19 patients) received 1 gram of TA diluted in 100 ml normal saline. Placebo group (19 patients) received 100 ml of normal saline only. The solution was purred in the pericardial and mediastinal cavities.</p> <p>Results</p> <p>Both groups were comparable in their baseline demographic and surgical characteristics. During the first 24 hours post-operatively, cumulative blood loss was significantly less in TA group (median of 626 ml) compared to Placebo group (median of 1040 ml) (P = 0.04). There was no significant difference in the post-op Packed RBCs transfusion between both groups (median of one unit in each) (P = 0.82). Significant less platelets transfusion required in TA group (median zero unit) than in placebo group (median 2 units) (P = 0.03). Apart from re-exploration for excessive surgical bleeding in one patient in TA group, no difference was found in morbidity or mortality between both groups.</p> <p>Conclusion</p> <p>Topical application of tranexamic acid in patients undergoing primary coronary artery bypass grafting led to a significant reduction in postoperative blood loss without adding extra risk to the patient.</p

Mid-term results in the treatment of varicose veins with N-butyl cyanoacrylate

PMID = 2866924

Internal compression therapy, a novel method in the treatment of deep venous insufficiency: 18-month clinical results

Objective: To present 18-month clinical results for internal compression therapy (ICT) applied percutaneously and as a novel method in the treatment of primary deep venous insufficiency. Material and Method: Thirty patients diagnosed with isolated primary femoral vein (FV) insufficiency between October 2017 and February 2018 were included in the study. Pre-procedural femoral vein diameters and reflux durations were measured. CEAP classification and Venous Clinical Severity Score (VCSS) were recorded. Pre-procedural CEAP classifications were CEAP 4 in nine patients and CEAP 3 in 21. Quality of life assessments were carried out using a Chronic Venous Insufficiency Questionnaire (CIVIQ-2). FV diameters were then reduced, and valve coaptation was established with the percutaneous application of hyaluronic acid and cyanoacrylate injected adjacent to a valve with non coapting leaflets. Venous diameters and reflux duration were again measured immediately after the procedure. Patients were followed-up at months 1, 6, and 18, at which times all parameters were re-evaluated. Results: Eighteen of the 30 patients were women, and 12 were men. The mean duration of the procedure was 22.7 ± 2.9 (20–30) min. Patients’ FV diameters were 12.8 (11–14.7) mm before the procedure, 9.9 (9–11.5) mm immediately after, and also 9.9 (9–11.2) mm after 1.5 years (p < 0.001). Pre-procedural reflux duration ranged between 2 and 6 (median: 3) sec, and no reflux was observed in any patient immediately or one month after the procedure (p < 0.001). At 18-month follow-up, reflux lasting only 1 sec was determined in two patients. VCSS scores were 11 (10–12) pre-procedurally and 6 (4–9) at 18 months (p < 0.001). Venous Quality of Life scores were 32 (30–36) before the procedure and 18 (14–24) at 18 months (p < 0.001). Conclusion: Preliminary investigation of the injection of cyanoacrylate and hyaluronic acid around one valve in an incompetent FV can result in improved hemodynamics, CEAP, VCSS and patient QOL at 18 months, without complications. © The Author(s) 2020

Intracardiac masses

Between 1991 and 1998, 8 patients (mean age, 29.6 years) underwent surgery for an intracardiac mass. There were 2 hydatid cysts, 1 angiosarcoma, and 5 myxomas. One patient with myxoma underwent a Syme's amputation due to lower extremity ischemia caused by embolization. The patient with angiosarcoma died of cardiopulmonary failure on the 9th postoperative day. The surviving patients experienced no mortality, complications, or recurrence during follow-up of 0.5 to 5 years

Studi Variasi Model Skeg Berdasarkan Resistance dan Pola Aliran yang Melewati Lambung Self Propulsion Barge

Aliran yang melewati lambung kapal dari ujung haluan hingga ke belakang buritan kapal selalu menghasilkan wakeyang merupakan perbedaan antara kecepatan kapal dan kecepatan air yang melalui propeller. Skegadalah salah satu komponen buritan yang bertujuan menjaga stabilitas kapal saat kapal melaju pada kecepatan tinggi serta membantu fluida mengalir lebih smooth melewati hull dan propeller kapal. Desain modelskegperlu direncanakan dengan baik karena jika tidak sesuai maka justru akan menghambat kinerja propeller. Penelitian inimenganalisa 4 bentuk skeg dengan pertimbangan resistance tambahan dan bentuk pola aliran yang ditimbulkan.Hasil pemodelan numerik didapatkan harga resistance kapal yang lebih kecil pada model 2 dan 4 yaitu 93,42 kN dan 97,43 kN. Untuk mendapatkan desain optimal maka model 2 dan 4 dipertimbangkan berdasarkan pola aliran dimana kecepatan aliran pada model 2 adalah 1,82 m/s lebih besar dari kecepatan aliran pada model 4 yaitu 1,68 m/s. Berdasarkan hasil analisa tahanan kapal dan pemodelan pola aliran maka disimpulkan bahwa desain yang paling optimal adalah skeg kondisi

Comparison of Endovenous Laser and Radiofrequency Ablation in Treating Varicose Veins in the Same Patient

PMID = 2676780